1
|
Braun M, Saini C, Sun JA, Shen LQ. The Role of Optical Coherence Tomography Angiography in Glaucoma. Semin Ophthalmol 2024; 39:412-423. [PMID: 38643350 DOI: 10.1080/08820538.2024.2343049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Revised: 04/08/2024] [Accepted: 04/09/2024] [Indexed: 04/22/2024]
Abstract
Glaucoma is the leading cause of irreversible vision loss and comprises a group of chronic optic neuropathies characterized by progressive retinal ganglion cell (RGC) loss. Various etiologies, including impaired blood supply to the optic nerve, have been implicated for glaucoma pathogenesis. Optical coherence tomography angiography (OCTA) is a non-invasive imaging modality for visualizing the ophthalmic microvasculature. Using blood flow as an intrinsic contrast agent, it distinguishes blood vessels from the surrounding tissue. Vessel density (VD) is mainly used as a metric for quantifying the ophthalmic microvasculature. The key anatomic regions for OCTA in glaucoma are the optic nerve head area including the peripapillary region, and the macular region. Specifically, VD of the superficial peripapillary and superficial macular microvasculature is reduced in glaucoma patients compared to unaffected subjects, and VD correlates with functional deficits measured by visual field (VF). This renders OCTA similar in diagnostic capabilities compared to structural retinal nerve fiber layer (RNFL) thickness measurements, especially in early glaucoma. Furthermore, in cases where RNFL thickness measurements are limited due to artifact or floor effect, OCTA technology can be used to evaluate and monitor glaucoma, such as in eyes with high myopia and eyes with advanced glaucoma. However, the clinical utility of OCTA in glaucoma management is limited due to the prevalence of imaging artifacts. Overall, OCTA can play a complementary role in structural OCT imaging and VF testing to aid in the diagnosis and monitoring of glaucoma.
Collapse
Affiliation(s)
- Maximilian Braun
- Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Chhavi Saini
- Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA
| | - Jessica A Sun
- Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA
| | - Lucy Q Shen
- Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA
| |
Collapse
|
2
|
Sato M, Kiyota N, Yabana T, Maekawa S, Tsuda S, Omodaka K, Himori N, Yokoyama Y, Nakazawa T. Sector-specific Association of Intraocular Pressure Dynamics in Dark-room Prone Testing and Visual Field Defect Progression in Glaucoma. Ophthalmol Glaucoma 2024; 7:372-379. [PMID: 38554811 DOI: 10.1016/j.ogla.2024.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 03/17/2024] [Accepted: 03/20/2024] [Indexed: 04/02/2024]
Abstract
PURPOSE To investigate sectoral differences in the relationship between intraocular pressure (IOP) dynamics during dark-room prone testing (DRPT) and visual field (VF) defect progression in primary open-angle glaucoma (POAG) patients. DESIGN Retrospective, longitudinal study. PARTICIPANTS This retrospective study included 116 eyes of 84 POAG patients who underwent DRPT and had at least 5 reliable VF tests conducted over a more than 2-year follow-up period. We excluded eyes with mean deviation worse than -20 dB or a history of intraocular surgery or laser treatment. METHODS Average total deviation (TD) was calculated in the superior, central, and inferior sectors of the Humphrey 24-2 or 30-2 program. During DRPT, IOP was measured in the sitting position, and after 60 minutes in the prone position in a dark room, IOP was measured again. The relationship between IOP change during DRPT, IOP after DRPT, and TD slope in each quadrant was analyzed with a linear mixed-effects model, adjusting for other potential confounding factors. MAIN OUTCOME MEASURES Total deviation slope in each quadrant, IOP change during DRPT, and IOP after DRPT. RESULTS Intraocular pressure after DRPT and IOP change during DRPT were 18.16 ± 3.42 mmHg and 4.92 ± 3.12 mmHg, respectively. Superior TD slope was significantly associated with both IOP after DRPT (β = -0.28, P = 0.003) and IOP change during DRPT (β = -0.21, P = 0.029), while central (β = -0.05, P = 0.595; β = -0.05; P = 0.622) and inferior (β = 0.05, P = 0.611; β = 0.01, P = 0.938) TD slopes were not. CONCLUSION Dark-room prone testing might be a useful test to predict the risk of superior VF defect progression in eyes with POAG. FINANCIAL DISCLOSURE(S) The author(s) have no proprietary or commercial interest in any materials discussed in this article.
Collapse
Affiliation(s)
- Masataka Sato
- Department of Ophthalmology, Tohoku University Graduate School of Medicine, Miyagi, Japan
| | - Naoki Kiyota
- Department of Ophthalmology, Tohoku University Graduate School of Medicine, Miyagi, Japan
| | - Takeshi Yabana
- Department of Ophthalmology, Tohoku University Graduate School of Medicine, Miyagi, Japan
| | - Shigeto Maekawa
- Department of Ophthalmology, Tohoku University Graduate School of Medicine, Miyagi, Japan
| | - Satoru Tsuda
- Department of Ophthalmology, Tohoku University Graduate School of Medicine, Miyagi, Japan
| | - Kazuko Omodaka
- Department of Ophthalmology, Tohoku University Graduate School of Medicine, Miyagi, Japan
| | - Noriko Himori
- Department of Ophthalmology, Tohoku University Graduate School of Medicine, Miyagi, Japan; Department of Aging Vision Healthcare, Tohoku University Graduate School of Biomedical Engineering, Miyagi, Japan
| | - Yu Yokoyama
- Department of Ophthalmology, Tohoku University Graduate School of Medicine, Miyagi, Japan
| | - Toru Nakazawa
- Department of Ophthalmology, Tohoku University Graduate School of Medicine, Miyagi, Japan; Department of Ophthalmic Imaging and Information Analytics, Tohoku University Graduate School of Medicine, Miyagi, Japan; Department of Retinal Disease Control, Tohoku University Graduate School of Medicine, Miyagi, Japan; Department of Advanced Ophthalmic Medicine, Tohoku University Graduate School of Medicine, Miyagi, Japan.
| |
Collapse
|
3
|
Takahashi N, Sato K, Kiyota N, Tsuda S, Murayama N, Nakazawa T. A ginger extract improves ocular blood flow in rats with endothelin-induced retinal blood flow dysfunction. Sci Rep 2023; 13:22715. [PMID: 38123793 PMCID: PMC10733345 DOI: 10.1038/s41598-023-49598-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Accepted: 12/10/2023] [Indexed: 12/23/2023] Open
Abstract
The aim of this study was to investigate the effect of a ginger extract on optic nerve head blood flow (ONH BF) under endothelin-1 (ET-1) stimulation. Using laser speckle flowgraphy, we measured ONH BF in brown Norway rats. To establish the ONH BF impairment profile under ET-1 stimulation, we administered an intravitreal injection of ET-1 under anesthesia. We then gave the ginger extract sublingually to assess its effect on ONH BF in both normal and ET-1-induced ischemic conditions. Post ET-1 injection, there were no significant changes in parameters including intraocular pressure or systemic factors. ONH BF showed a dose-dependent decline after ET-1 injection, with a significant reduction after a 2.50 pmol ET-1 dose. Sublingual administration of the ginger extract significantly improved ONH BF in both normal and ET-1-stimulated rats. This suggests that our newly developed supplement for improving ONH BF has a potential role in retinal ischemic diseases, including glaucoma.
Collapse
Affiliation(s)
- Nana Takahashi
- Department of Ophthalmology, Tohoku University Graduate School of Medicine, 1-1, Seiryo, Aoba, Sendai, Miyagi, 980-8574, Japan
| | - Kota Sato
- Department of Ophthalmology, Tohoku University Graduate School of Medicine, 1-1, Seiryo, Aoba, Sendai, Miyagi, 980-8574, Japan
- Department of Advanced Ophthalmic Medicine, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Naoki Kiyota
- Department of Ophthalmology, Tohoku University Graduate School of Medicine, 1-1, Seiryo, Aoba, Sendai, Miyagi, 980-8574, Japan
| | - Satoru Tsuda
- Department of Ophthalmology, Tohoku University Graduate School of Medicine, 1-1, Seiryo, Aoba, Sendai, Miyagi, 980-8574, Japan
| | - Namie Murayama
- Department of Ophthalmology, Tohoku University Graduate School of Medicine, 1-1, Seiryo, Aoba, Sendai, Miyagi, 980-8574, Japan
| | - Toru Nakazawa
- Department of Ophthalmology, Tohoku University Graduate School of Medicine, 1-1, Seiryo, Aoba, Sendai, Miyagi, 980-8574, Japan.
- Department of Advanced Ophthalmic Medicine, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan.
- Department of Ophthalmic Imaging and Information Analytics, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan.
- Department of Retinal Disease Control, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan.
| |
Collapse
|
4
|
Takahashi N, Sato K, Kiyota N, Yamazaki M, Kunikane E, Nakazawa T. The effect of a brinzolamide/brimonidine fixed combination on optic nerve head blood flow in rabbits. PLoS One 2023; 18:e0295122. [PMID: 38051718 DOI: 10.1371/journal.pone.0295122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 11/14/2023] [Indexed: 12/07/2023] Open
Abstract
PURPOSE The purpose of this study was to investigate the effect of a 1% brinzolamide and 0.1% brimonidine fixed combination (BBFC) on ONH blood flow (BF) in rabbits. METHODS A crossover study was conducted on pigmented rabbits; a physiological saline solution, brinzolamide, or BBFC was administered for eight days. ONH BF, intraocular pressure (IOP) and systemic parameters were measured before the eighth day's first dose and at 6, 9, 12, and 14 hours after the dose. ONH BF was assessed using laser speckle flowgraphy, and mean blur rate (MBR) values were calculated. The percentage against baseline of each parameter was calculated, and intergroup comparisons were performed at each time point. RESULTS There were no significant differences in the percentage change in systemic parameters. At 6 hours after administration, the BBFC group showed a significantly higher percentage change in large vessel area-MBR (%MV) compared to the control group (98.6±16.8%MV vs. 81.3±7.9%MV, P = 0.03). On the other hand, the brinzolamide group did not show a significant difference. Both the brinzolamide and BBFC groups had significantly lower percentage change in IOP (%IOP) compared to the control group (90.6±5.0%IOP, 93.3±2.9%IOP, and 99.2±1.7%IOP, respectively, P < 0.01). CONCLUSION BBFC effectively reduces IOP and mitigates diurnal fluctuation-induced decreases in ONH BF.
Collapse
Affiliation(s)
- Nana Takahashi
- Department of Ophthalmology, Tohoku University Graduate School of Medicine, Miyagi, Japan
| | - Kota Sato
- Department of Ophthalmology, Tohoku University Graduate School of Medicine, Miyagi, Japan
- Department of Advanced Ophthalmic Medicine, Tohoku University Graduate School of Medicine, Miyagi, Japan
| | - Naoki Kiyota
- Department of Ophthalmology, Tohoku University Graduate School of Medicine, Miyagi, Japan
| | - Mai Yamazaki
- Department of Ophthalmology, Tohoku University Graduate School of Medicine, Miyagi, Japan
- Seiryo Eye Clinic, Miyagi, Japan
| | - Eriko Kunikane
- Department of Research and Development Division, Senju Pharmaceutical Co., Ltd., Osaka, Japan
| | - Toru Nakazawa
- Department of Ophthalmology, Tohoku University Graduate School of Medicine, Miyagi, Japan
- Department of Advanced Ophthalmic Medicine, Tohoku University Graduate School of Medicine, Miyagi, Japan
- Department of Ophthalmic Imaging and Information Analytics, Tohoku University Graduate School of Medicine, Miyagi, Japan
- Department of Retinal Disease Control, Tohoku University Graduate School of Medicine, Miyagi, Japan
| |
Collapse
|
5
|
Takahashi N, Kiyota N, Kunikata H, Yamazaki M, Nishimura T, Shiga Y, Aoyagi H, Shidomi M, Tsuda T, Ohtsuka T, Tomida T, Nakazawa T. Vasoreactivity of the optic nerve head, nailfold, and facial skin in response to cold provocation in normal-tension glaucoma patients. BMC Ophthalmol 2023; 23:316. [PMID: 37438715 DOI: 10.1186/s12886-023-03059-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 06/23/2023] [Indexed: 07/14/2023] Open
Abstract
BACKGROUND The dysfunction of optic nerve head (ONH) hemodynamics has been suggested to be involved in the pathogenesis of normal-tension glaucoma (NTG). The aim of this study was to compare vasoreactivity in the ONH, nailfold, and facial skin in response to cold-water provocation in NTG patients and healthy controls. METHODS We performed cold-water provocation in 14 eyes of 14 NTG patients and 15 eyes of 15 age-matched control subjects. Laser speckle flowgraphy-derived tissue-area mean blur rate (MT), skin blood flowmetry-derived pulse wave amplitude (PA), nailfold capillaroscopy-derived nailfold capillary diameter, and other clinical parameters were recorded at baseline and 4 and 6 min after the cold stimulus. We compared changes (as percentages) in these variables in the NTG and control subjects with a linear mixed-effects model and evaluated correlations between these changes with Spearman's rank correlation coefficient. RESULTS The interaction term between the NTG group (reference, control group) and the 4-min protocol step (reference, baseline) significantly affected the changes in MT, nailfold capillary diameter and PA (β = -9.51%, P = 0.017, β = -20.32%, P = 0.002; β = + 18.06%, P = 0.017, respectively). The change in MT was positively correlated with the change in nailfold capillary diameter, and negatively correlated with the change in PA (r = 0.39, P = 0.036; r = -0.40, P = 0.031, respectively). CONCLUSION NTG patients showed abnormal vasoconstriction in the ONH and nailfold and vasodilation in the facial skin in response to cold-water provocation.
Collapse
Affiliation(s)
- Nana Takahashi
- Department of Ophthalmology, Tohoku University Graduate School of Medicine, Miyagi, Japan
| | - Naoki Kiyota
- Department of Ophthalmology, Tohoku University Graduate School of Medicine, Miyagi, Japan
| | - Hiroshi Kunikata
- Department of Ophthalmology, Tohoku University Graduate School of Medicine, Miyagi, Japan
- Department of Retinal Disease Control, Tohoku University Graduate School of Medicine, Miyagi, Japan
| | - Mai Yamazaki
- Department of Ophthalmology, Tohoku University Graduate School of Medicine, Miyagi, Japan
- Seiryo Eye Clinic, Miyagi, Japan
| | - Takayuki Nishimura
- Department of Ophthalmology, Tohoku University Graduate School of Medicine, Miyagi, Japan
| | - Yukihiro Shiga
- Department of Ophthalmology, Tohoku University Graduate School of Medicine, Miyagi, Japan
| | - Hisae Aoyagi
- Department of Health Science Research Planning Division, Rohto Pharmaceutical Co., Ltd, Osaka, Japan
| | - Miwako Shidomi
- Department of Health Science Research Planning Division, Rohto Pharmaceutical Co., Ltd, Osaka, Japan
| | - Tomohiro Tsuda
- Department of Internal Medicine and Food Development Division, Rohto Pharmaceutical Co., Ltd, Osaka, Japan
| | - Toshihiko Ohtsuka
- Department of Advanced Development, Casio Computer Co., Ltd, Tokyo, Japan
| | - Takahiro Tomida
- Department of Advanced Development, Casio Computer Co., Ltd, Tokyo, Japan
| | - Toru Nakazawa
- Department of Ophthalmology, Tohoku University Graduate School of Medicine, Miyagi, Japan.
- Department of Retinal Disease Control, Tohoku University Graduate School of Medicine, Miyagi, Japan.
- Department of Ophthalmic Imaging and Information Analytics, Tohoku University Graduate School of Medicine, Miyagi, Japan.
- Department of Advanced Ophthalmic Medicine, Tohoku University Graduate School of Medicine, Miyagi, Japan.
| |
Collapse
|
6
|
Sex differences in the association between systemic oxidative stress status and optic nerve head blood flow in normal-tension glaucoma. PLoS One 2023; 18:e0282047. [PMID: 36827337 PMCID: PMC9955941 DOI: 10.1371/journal.pone.0282047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 02/06/2023] [Indexed: 02/25/2023] Open
Abstract
PURPOSE To investigate the association of systemic oxidative stress markers and optic nerve head (ONH) blood flow in normal-tension glaucoma (NTG) patients, as well as sex differences in this association. METHODS This was a cross-sectional study of 235 eyes with NTG of 134 patients (56 male, 78 female; mean age, 60.9±14.1 years). Laser speckle flowgraphy (LSFG) was used to measure ONH blood flow (mean blur rate in the tissue area of the ONH; MBR-T) and LSFG pulse-waveform parameters, including flow acceleration index in the tissue area of the ONH (FAI-T). Oxidative stress markers, diacron-reactive oxygen metabolites (d-ROMs), and biological antioxidant potential (BAP) were measured with a free radical elective evaluator. Spearman's rank correlation test and a multivariate linear mixed-effect model were used to investigate factors associated with ONH blood flow. RESULTS MBR-T was significantly correlated with age (rs = -0.28, p < 0.001), mean arterial pressure (rs = -0.20, p = 0.002), intraocular pressure (rs = 0.24, p < 0.001), peripapillary retinal nerve fiber layer thickness (rs = 0.62, p < 0.001), and disc area (rs = -0.26, p < 0.001), but not with serum d-ROM level. Separate analyses of the subjects divided by sex showed that BAP was positively correlated to MBR-T (rs = 0.21, p = 0.036) and FAI-T (rs = 0.36, p < 0.001) only in male subjects. Similarly, BAP was significantly associated with MBR-T (β = 0.25, p = 0.026) and FAI-T (β = 0.37, p < 0.001) in male subjects in a multivariate linear mixed-effect model. CONCLUSION A lower serum antioxidant level, as indicated by BAP, was associated with reduced ONH blood flow only in male NTG patients. Our findings suggest that there are sex differences in the involvement of oxidative stress in the pathogenesis of reduced ocular blood flow in NTG.
Collapse
|
7
|
Köse HC, Tekeli O. Comparison of microvascular parameters and diagnostic ability of optical coherence tomography angiography between eyes with primary angle closure glaucoma and primary open angle glaucoma. Photodiagnosis Photodyn Ther 2022; 40:103114. [PMID: 36096437 DOI: 10.1016/j.pdpdt.2022.103114] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 08/21/2022] [Accepted: 09/07/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND To investigate and compare the peripapillary and macular microvascular parameters between eyes with primary angle closure glaucoma (PACG) and primary open-angle glaucoma (POAG) using optical coherence tomography angiography (OCTA). METHODS Seventy-nine eyes of 43 patients with primary angle closure glaucoma (PACG), 78 eyes of 43 patients with primary open-angle glaucoma (POAG), 64 eyes of 35 patients with primary angle closure (PAC), and 73 eyes of 40 control subjects underwent imaging with OCTA. Perfusion density (PD) and vessel density (VD) for the macular area, and PD and flux index (FI) for the peripapillary area were calculated automatically. The area under receiver operator characteristic curves (AUC) were constructed to distinguish PACG and POAG eyes from healthy control eyes. RESULTS The peripapillary FI in all quadrants and PD and VD of the macular outer circle in superior and inferior quadrants were significantly lower in PACG and POAG eyes than in control eyes. The peripapillary FI in the inferior quadrant was significantly lower in the POAG group than in the PACG group (0.348 ± 0.06 vs. 0.369 ± 0.06, p = 0.04). The remaining OCTA parameters in the peripapillary and macular area did not show a significant difference between the POAG and PACG groups. Eyes with PAC presented significantly lower PD and VD than healthy control eyes at the superior and inferior quadrant of the macular outer circle, while retinal nerve fiber layer and ganglion cell inner complex thickness were not significantly different from than control eyes. The best diagnostic parameter was peripapillary FI in both PACG (AUC: 0.922) and POAG (AUC: 0.938) eyes. CONCLUSIONS We found significantly lower peripapillary FI in the inferior quadrant in POAG eyes compared to the PACG eyes, which may indicate the different underlying pathogenesis between POAG and PACG. The PAC eyes had lower macular PD and VD than normal eyes. This suggests that retinal vascular impairment may develop earlier than structural damage in PAC eyes.
Collapse
Affiliation(s)
- Helin Ceren Köse
- Ankara University Faculty of Medicine, Department of Ophthalmology, Ankara, Turkey.
| | - Oya Tekeli
- Ankara University Faculty of Medicine, Department of Ophthalmology, Ankara, Turkey
| |
Collapse
|
8
|
Evaluation of Microcirculation in Optic Nerve Head Using Laser Speckle Flowgraphy in Active Thyroid Eye Disease. BIOMED RESEARCH INTERNATIONAL 2022; 2022:9115270. [PMID: 35342747 PMCID: PMC8948602 DOI: 10.1155/2022/9115270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Revised: 01/17/2022] [Accepted: 02/05/2022] [Indexed: 11/23/2022]
Abstract
Background Laser speckle flowgraphy (LSFG) can be used to estimate optic nerve blood flow. This study used LSFG to evaluate optic nerve microcirculation in patients with thyroid eye disease (TED). Methods This was a retrospective review of patients with active TED who underwent LSFG between October 2020 and June 2021. The mean blur rate (MBR) for different severities of active TED was analyzed by one-way analysis of variance (ANOVA). Results A total of 30 patients (60 eyes) with a diagnosis of active TED who underwent LSFG were included. The mean age was 49 (range, 33–74) years. Mean best-corrected visual acuity was the worst in the group with sight-threatening active TED (0.29 ± 0.33 logarithm of the minimum angle of resolution, p = 0.01). The MBR-overall was the highest in the group with mild active TED (28.5 ± 2.7), followed by that in the moderate to severe (23.6 ± 3.2), and in the sight-threatening (20.2 ± 4.3) active TED groups (p < 0.001). The MBR-vessel was 57.1, 47.0, and 39.3 in the mild, moderate to severe, and sight-threatening active TED groups, respectively (p < 0.001). The MBR-tissue was 16.9, 14.4, and 12.0 in the mild, moderate to severe, and sight-threatening active TED groups, respectively (p < 0.001). Conclusions This study demonstrates that optic nerve blood flow is lower with more severe active TED. In addition, LSFG is an effective, objective, and noninvasive method for evaluating the severity of TED.
Collapse
|
9
|
Calzetti G, Mursch‐Edlmayr AS, Bata AM, Ungaro N, Mora P, Chua J, Schmidl D, Bolz M, Garhöfer G, Gandolfi S, Schmetterer L, Wong D. Measuring optic nerve head perfusion to monitor glaucoma: a study on structure-function relationships using laser speckle flowgraphy. Acta Ophthalmol 2022; 100:e181-e191. [PMID: 33880888 DOI: 10.1111/aos.14862] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2020] [Revised: 02/21/2021] [Accepted: 03/16/2021] [Indexed: 12/31/2022]
Abstract
PURPOSE We aimed to describe the global and localized correlations among visual field (VF) sensitivity, optic nerve head (ONH) perfusion measured by laser speckle flowgraphy (LSFG) and neural structure measured by optical coherence tomography (OCT) in open-angle glaucoma (OAG) and to compare the floor effect for LSFG and OCT. METHODS Cross-sectional, multicenter study including one eye each from fifty OAG patients (mean age 69.3 years; average VF mean deviation, MD, -8.5 dB, range -25.17 to 0.85 dB) and fifty-one controls. Patients underwent SITA standard 24-2 automated perimetry and measurement of ONH perfusion, peripapillary retinal nerve fibre layer thickness (RNFLT) and macular ganglion cell-inner plexiform layer thickness (GCIPLT). We tested the presence of a significant change (breakpoint) in the correlation slope with VF sensitivity to assess floor effect. RESULTS The correlation between the LSFG parameter Mean All (MA) of the global disc area and MD (r = 0.56, p < 0.001) did not show a breakpoint, in contrast to the correlations between MD and OCT global parameters, which showed breakpoints at -8.53 and -4.05 dB for RNFLT and GCIPLT, respectively. Global and localized correlations with VF sensitivity were stronger for LSFG compared to OCT. In particular, LSFG outperformed OCT in the correlation with the central VF sector (r = 0.50, p < 0.001 and r = 0.06, p = 0.67 for MA and RNFLT, respectively). CONCLUSION The global and sectoral correlations with VF sensitivity and the favourable floor effect compared to OCT indicate LSFG as a promising tool to monitor progression particularly in late-stage glaucoma. Further longitudinal studies are warranted.
Collapse
Affiliation(s)
- Giacomo Calzetti
- Department of Ophthalmology University Hospital of Parma Parma Italy
- Institute of Molecular and Clinical Ophthalmology Basel Basel Switzerland
| | | | - Ahmed M. Bata
- Department of Clinical Pharmacology Medical University of Vienna Vienna Austria
- Vienna Health Association Kaiser Franz Josef (Favoriten) Hospital Vienna Austria
| | - Nicola Ungaro
- Department of Ophthalmology University Hospital of Parma Parma Italy
| | - Paolo Mora
- Department of Ophthalmology University Hospital of Parma Parma Italy
| | - Jacqueline Chua
- Singapore Eye Research Institute Singapore National Eye Centre Singapore Singapore
- Academic Clinical Program Duke‐NUS Medical School Singapore Singapore
| | - Doreen Schmidl
- Department of Clinical Pharmacology Medical University of Vienna Vienna Austria
| | - Matthias Bolz
- Department of Ophthalmology Kepler University Clinic Johannes Kepler University Linz Austria
| | - Gerhard Garhöfer
- Department of Clinical Pharmacology Medical University of Vienna Vienna Austria
| | - Stefano Gandolfi
- Department of Ophthalmology University Hospital of Parma Parma Italy
| | - Leopold Schmetterer
- Institute of Molecular and Clinical Ophthalmology Basel Basel Switzerland
- Department of Clinical Pharmacology Medical University of Vienna Vienna Austria
- Singapore Eye Research Institute Singapore National Eye Centre Singapore Singapore
- Academic Clinical Program Duke‐NUS Medical School Singapore Singapore
- School of Chemical and Biomedical Engineering Nanyang Technological University Singapore Singapore
| | - Damon Wong
- Singapore Eye Research Institute Singapore National Eye Centre Singapore Singapore
- SERI‐NTU Advanced Ocular Engineering (STANCE) Singapore Singapore
- NTU Institute of Health Technologies Singapore Singapore
| |
Collapse
|
10
|
Lu Y, Wang RK. Removing dynamic distortions from laser speckle flowgraphy using Eigen-decomposition and spatial filtering. JOURNAL OF BIOPHOTONICS 2022; 15:e202100294. [PMID: 34787958 DOI: 10.1002/jbio.202100294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 10/29/2021] [Accepted: 11/16/2021] [Indexed: 06/13/2023]
Abstract
Laser speckle flowgraphy (LSFG) has been widely used in the investigation of blood flows in ophthalmology. However, the dynamic changes of the ocular optics can impose artificial contrasts to the LSFG, corrupting the detection of both retinal vasculature and blood pulsation at the posterior segment of the human eye. In this study, we propose to use Eigen-decomposition method to separate the spatially and temporally varying speckle patterns from the static tissues. Spatial filtering is further applied to remove the distortion-correlated modulation of the speckle patterns. We experimentally show that with the proposed method, the integrity of blood vessels is significantly improved and the distortions in pulse waveforms can be well corrected.
Collapse
Affiliation(s)
- Yiming Lu
- Department of Bioengineering, University of Washington, Seattle, Washington, USA
| | - Ruikang K Wang
- Department of Bioengineering, University of Washington, Seattle, Washington, USA
| |
Collapse
|
11
|
Coffey AM, Hutton EK, Combe L, Bhindi P, Gertig D, Constable PA. Optical coherence tomography angiography in primary eye care. Clin Exp Optom 2021; 104:3-13. [PMID: 32285493 DOI: 10.1111/cxo.13068] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Optical coherence tomography angiography (OCT-A) is a non-invasive imaging modality for assessing the vasculature within ocular structures including the retina, macula, choroid and optic nerve. OCT-A has a wide range of clinical applications in various optometric conditions which have been independently reported in the literature. This paper aims to present a review of the current literature on the clinical application of OCT-A in optometric practice as well as to analyse and evaluate the quality of the available evidence. This review included 78 articles from a literature search conducted on 26 May 2019 across the following databases: Cochrane Library of Systematic Reviews, Medline, Scopus and Web of Science. Primary ocular pathologies discussed in this review include glaucoma, diabetic retinopathy, age-related macular degeneration, myopia, acquired and congenital macular dystrophies, epiretinal membrane, retinal vein occlusion, retinitis pigmentosa, choroidal melanoma, uveitis, central serous chorioretinopathy, amblyopia and optic neuropathies. Primary outcome variables included vessel density, foveal avascular zone area and diameter, flow velocity and flow index. This review aims to evaluate the evidence available for OCT-A applications in diagnosis and prognosis of ocular conditions in an optometric setting.
Collapse
Affiliation(s)
- Alexandra M Coffey
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University , Adelaide, Australia
| | - Emily K Hutton
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University , Adelaide, Australia
| | - Louise Combe
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University , Adelaide, Australia
| | - Pooja Bhindi
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University , Adelaide, Australia
| | - Demi Gertig
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University , Adelaide, Australia
| | - Paul A Constable
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University , Adelaide, Australia
| |
Collapse
|
12
|
Gu C, Li A, Yu L. Diagnostic performance of laser speckle flowgraphy in glaucoma: a systematic review and meta-analysis. Int Ophthalmol 2021; 41:3877-3888. [PMID: 34327617 DOI: 10.1007/s10792-021-01954-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Accepted: 07/09/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE To evaluate the diagnostic value of laser speckle flowgraphy (LSFG) in glaucoma by investigating the mean blur rate (MBR) in the optic nerve head. METHODS Systematic literature search was performed in the CENTRAL, Web of Science, PubMed, and EMBASE databases to obtain relevant studies published until December 2020 without restrictions. The Newcastle-Ottawa Scale (NOS) was used for study quality assessment. The outcome measures included the MBRs of the entire (MA), vascular (MV), and tissue (MT) areas. Subgroup analyses were performed according to glaucoma type. All data were analyzed using RevMan and Comprehensive Meta-Analysis 3.3 software. RESULTS Fifteen studies, including 692 glaucomatous and 386 healthy eyes, were included. Of these, 11 studies reported the MA, MV, and MT, three studies only reported MT, and one study only reported MV. All were classified as case-control studies and had good NOS scores. The meta-analysis showed that the MA and MT were significantly reduced in glaucomatous eyes (mean difference [MD] - 5.59, 95% confidence interval [CI] - 6.19 to - 4.99, p = 0.1; MD - 2.2, 95% CI - 2.49 to - 1.91, p = 0.07, respectively) with moderate heterogeneity (p = 0.1, I2 = 38%; p = 0.07, I2 = 39%, respectively). There was also a significant difference in the MV between glaucomatous and healthy eyes (MD - 5.92, 95% CI - 7.77 to - 4.07) with significant heterogeneity (p = 0.0003, I2 = 69%). The subgroup analyses revealed significant differences in the MBR among different glaucoma types. CONCLUSIONS Glaucoma is closely related to ocular blood flow changes. This meta-analysis suggests that LSFG is a feasible diagnostic tool for glaucoma. However, further longitudinal prospective studies are needed.
Collapse
Affiliation(s)
- Chao Gu
- Department of Ophthalmology, Affiliated Hospital of Southwest Medical University, Luzhou, 646000, Sichuan, China
| | - Ailing Li
- Department of the School of Public Health of Southwest Medical University, Luzhou, 646000, Sichuan, China
| | - Ling Yu
- Department of Ophthalmology, Affiliated Hospital of Southwest Medical University, Luzhou, 646000, Sichuan, China.
| |
Collapse
|
13
|
WuDunn D, Takusagawa HL, Sit AJ, Rosdahl JA, Radhakrishnan S, Hoguet A, Han Y, Chen TC. OCT Angiography for the Diagnosis of Glaucoma: A Report by the American Academy of Ophthalmology. Ophthalmology 2021; 128:1222-1235. [PMID: 33632585 DOI: 10.1016/j.ophtha.2020.12.027] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 12/28/2020] [Accepted: 12/28/2020] [Indexed: 01/26/2023] Open
Abstract
PURPOSE To review the current published literature on the use of OCT angiography (OCTA) to help detect changes associated with the diagnosis of primary open-angle glaucoma. METHODS Searches of the peer-reviewed literature were conducted in March 2018, June 2018, April 2019, December 2019, and June 2020 in the PubMed and Cochrane Library databases. Abstracts of 459 articles were examined to exclude reviews and non-English articles. After inclusion and exclusion criteria were applied, 75 articles were selected and the panel methodologist rated them for strength of evidence. Three articles were rated level I and 57 articles were rated level II. The 15 level III articles were excluded. RESULTS OCT angiography can detect decreased capillary vessel density within the peripapillary nerve fiber layer (level II) and macula (level I and II) in patients with suspected glaucoma, preperimetric glaucoma, and perimetric glaucoma. The degree of vessel density loss correlates significantly with glaucoma severity both overall and topographically (level II) as well as longitudinally (level I). For differentiating glaucomatous from healthy eyes, some studies found that peripapillary and macular vessel density measurements by OCTA show a diagnostic ability (area under the receiver operating characteristic curve) that is comparable with structural OCT retinal nerve fiber and ganglion cell thickness measurements, whereas other studies found that structural OCT measurements perform better. Choroidal or deep-layer microvasculature dropout as measured by OCTA is also associated with glaucoma damage (level I and II). Lower peripapillary and macular vessel density and choroidal microvasculature dropout are associated with faster rates of disease progression (level I and II). CONCLUSIONS Vessel density loss associated with glaucoma can be detected by OCTA. Peripapillary, macular, and choroidal vessel density parameters may complement visual field and structural OCT measurements in the diagnosis of glaucoma.
Collapse
Affiliation(s)
- Darrell WuDunn
- University of Florida College of Medicine - Jacksonville, Department of Ophthalmology, Jacksonville, Florida
| | - Hana L Takusagawa
- VA Eugene Healthcare Center, Eugene, Oregon, and Casey Eye Institute, Oregon Health & Sciences University, Portland, Oregon
| | - Arthur J Sit
- Mayo Clinic, Department of Ophthalmology, Rochester, Minnesota
| | | | - Sunita Radhakrishnan
- Glaucoma Center of San Francisco, Glaucoma Research and Education Group, San Francisco, California
| | - Ambika Hoguet
- Ophthalmic Consultants of Boston, Boston, Massachusetts
| | - Ying Han
- UCSF Medical Center, San Francisco, California
| | - Teresa C Chen
- Harvard Medical School, Department of Ophthalmology, Massachusetts Eye & Ear, Glaucoma Service, Boston, Massachusetts
| |
Collapse
|
14
|
Anraku A, Enomoto N, Tomita G, Iwase A, Sato T, Shoji N, Shiba T, Nakazawa T, Sugiyama K, Nitta K, Araie M. Ocular and Systemic Factors Affecting Laser Speckle Flowgraphy Measurements in the Optic Nerve Head. Transl Vis Sci Technol 2021; 10:13. [PMID: 33510952 PMCID: PMC7804520 DOI: 10.1167/tvst.10.1.13] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Accepted: 12/05/2020] [Indexed: 01/12/2023] Open
Abstract
Purpose To investigate the ocular and systemic factors related to glaucoma and to be adjusted for interindividual comparison of ocular blood flow measurement results by laser speckle flowgraphy (LSFG) obtained from the optic nerve head (ONH) in normal Japanese individuals. Methods A multicenter, prospective cross-sectional study was conducted. The ONH tissue-area and vessel-area mean blur rate (MT and MV) were evaluated using LSFG and ONH structural parameters using planimetric methods. Multivariate linear mixed-effects modeled regression analysis was used to identify the contributing factors to the MT and MV. The explanatory variables were age; gender; smoking history; body mass index; mean arterial pressure (MAP); heart rate; intraocular pressure; axial length (AL); disc, rim, cup, and β-peripapillary atrophy (β-PPA) areas; and central retinal artery and vein equivalents. Results In total, 195 eyes of 126 healthy individuals with an average age of 48.1 years were included. Multivariate analysis showed that MAP and disc area had a negative (P < 0.001) correlation, whereas β-PPA area had a positive correlation with MT (P = 0.010). Age and AL had a negative correlation (P = 0.001 and P = 0.011, respectively), whereas cup area had a positive correlation (P = 0.012) with MV. Conclusions Interindividual comparison of MT or MV must be adjusted for both systemic factors (blood pressure or age) and local ocular factors (AL and disc, cup, or β-PPA area). Translational Relevance Our results provided reference data on the LSFG measurement and are important in comparing ocular blood flow between individuals using LSFG.
Collapse
Affiliation(s)
- Ayako Anraku
- Department of Ophthalmology, Toho University Ohashi Medical Center, Tokyo, Japan
| | - Nobuko Enomoto
- Department of Ophthalmology, Toho University Ohashi Medical Center, Tokyo, Japan
| | - Goji Tomita
- Department of Ophthalmology, Toho University Ohashi Medical Center, Tokyo, Japan
| | - Aiko Iwase
- Tajimi Iwase Eye Clinic, Tajimi, Gifu, Japan
| | - Takashi Sato
- Department of Ophthalmology, Toho University Ohashi Medical Center, Tokyo, Japan
| | - Nobuyuki Shoji
- Department of Ophthalmology, Kitasato University School of Medicine, Kanagawa, Japan
| | - Tomoaki Shiba
- Department of Ophthalmology, School of Medicine, Toho University, Tokyo, Japan
| | - Toru Nakazawa
- Department of Ophthalmology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Kazuhisa Sugiyama
- Department of Ophthalmology, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan
| | - Koji Nitta
- Fukui-ken Saiseikai Hospital, Fukui, Japan
| | - Makoto Araie
- Kanto Central Hospital of the Mutual Aid Association of Public School Teachers, Tokyo, Japan
| |
Collapse
|
15
|
Kiyota N, Shiga Y, Omodaka K, Pak K, Nakazawa T. Time-Course Changes in Optic Nerve Head Blood Flow and Retinal Nerve Fiber Layer Thickness in Eyes with Open-angle Glaucoma. Ophthalmology 2020; 128:663-671. [PMID: 33065167 DOI: 10.1016/j.ophtha.2020.10.010] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 09/21/2020] [Accepted: 10/07/2020] [Indexed: 01/20/2023] Open
Abstract
PURPOSE To determine whether decreased optic nerve head (ONH) blood flow (BF) precedes or follows decreased circumpapillary retinal nerve fiber layer thickness (cpRNFLT) in eyes with open-angle glaucoma (OAG). DESIGN Retrospective, longitudinal study. PARTICIPANTS This study followed up 350 eyes of 225 OAG patients for at least 2 years and collected data from each patient from at least 5 examinations obtained with laser speckle flowgraphy (LSFG) and OCT. METHODS In the superior, temporal, and inferior ONH quadrants, tissue area mean blur rate (MT), representing ONH tissue BF, was measured with LSFG, whereas cpRNFLT was measured with OCT. A multivariate linear mixed-effects model was used to identify potential predictors of faster MT decrease, adjusting for possible confounding factors. Based on these results, each quadrant of each patient was assigned a risk point if the quadrant was the superior or temporal, if patient age was older than the median (61 years), and if patient pulse rate was higher than median (74 beats per minute). The quadrants were then compared with a mixed-effects Cox model for MT and cpRNFLT changes, defined as a difference between the baseline value and the values from the latest 2 consecutive follow-up visits of more than 1.96 × the corresponding coefficient of variation. MAIN OUTCOME MEASURES Ophthalmic and systemic variables and MT and cpRNFLT in the superior, temporal, and inferior quadrants. RESULTS The multivariate model showed that MT decrease was faster in older patients with higher pulse rate and slower in inferior quadrants (P < 0.05). Quadrants with 0 risk points showed primary cpRNFLT decrease (P = 0.048), 1-risk point quadrants showed simultaneous cpRNFLT and MT decrease (P = 0.260), and 2-risk point and 3-risk point quadrants showed primary MT decrease (P < 0.001). CONCLUSIONS Older patients with higher pulse rate are at greater risk of a primary reduction in ONH tissue BF, that is, preceding cpRNFLT decrease, in the superior and temporal quadrants.
Collapse
Affiliation(s)
- Naoki Kiyota
- Department of Ophthalmology, Tohoku University Graduate School of Medicine, Miyagi, Japan
| | - Yukihiro Shiga
- Department of Ophthalmology, Tohoku University Graduate School of Medicine, Miyagi, Japan; Department of Ophthalmic Imaging and Information Analytics, Tohoku University Graduate School of Medicine, Miyagi, Japan
| | - Kazuko Omodaka
- Department of Ophthalmology, Tohoku University Graduate School of Medicine, Miyagi, Japan; Department of Ophthalmic Imaging and Information Analytics, Tohoku University Graduate School of Medicine, Miyagi, Japan
| | - Kyongsun Pak
- Division of Biostatistics, Department of Data Management, Center for Clinical Research, National Center for Child Health and Development, Tokyo, Japan
| | - Toru Nakazawa
- Department of Ophthalmology, Tohoku University Graduate School of Medicine, Miyagi, Japan; Department of Ophthalmic Imaging and Information Analytics, Tohoku University Graduate School of Medicine, Miyagi, Japan; Department of Retinal Disease Control, Tohoku University Graduate School of Medicine, Miyagi, Japan; Department of Advanced Ophthalmic Medicine, Tohoku University Graduate School of Medicine, Miyagi, Japan.
| |
Collapse
|
16
|
Bekkers A, Borren N, Ederveen V, Fokkinga E, Andrade De Jesus D, Sánchez Brea L, Klein S, van Walsum T, Barbosa‐Breda J, Stalmans I. Microvascular damage assessed by optical coherence tomography angiography for glaucoma diagnosis: a systematic review of the most discriminative regions. Acta Ophthalmol 2020; 98:537-558. [PMID: 32180360 PMCID: PMC7497179 DOI: 10.1111/aos.14392] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Accepted: 02/09/2020] [Indexed: 01/14/2023]
Abstract
A growing number of studies have reported a link between vascular damage and glaucoma based on optical coherence tomography angiography (OCTA) imaging. This multitude of studies focused on different regions of interest (ROIs) which offers the possibility to draw conclusions on the most discriminative locations to diagnose glaucoma. The objective of this work was to review and analyse the discriminative capacity of vascular density, retrieved from different ROIs, on differentiating healthy subjects from glaucoma patients. PubMed was used to perform a systematic review on the analysis of glaucomatous vascular damage using OCTA. All studies up to 21 April 2019 were considered. The ROIs were analysed by region (macula, optic disc and peripapillary region), layer (superficial and deep capillary plexus, avascular, whole retina, choriocapillaris and choroid) and sector (according to the Garway-Heath map). The area under receiver operator characteristic curve (AUROC) and the statistical difference (p-value) were used to report the importance of each ROI for diagnosing glaucoma. From 96 screened studies, 43 were eligible for this review. Overall, the peripapillary region showed to be the most discriminative region with the highest mean AUROC (0.80 ± 0.09). An improvement of the AUROC from this region is observed when a sectorial analysis is performed, with the highest AUROCs obtained at the inferior and superior sectors of the superficial capillary plexus in the peripapillary region (0.86 ± 0.03 and 0.87 ± 0.10, respectively). The presented work shows that glaucomatous vascular damage can be assessed using OCTA, and its added value as a complementary feature for glaucoma diagnosis depends on the region of interest. A sectorial analysis of the superficial layer at the peripapillary region is preferable for assessing glaucomatous vascular damage.
Collapse
Affiliation(s)
- Amerens Bekkers
- Biomedical Imaging Group RotterdamDepartment of Radiology & Nuclear MedicineErasmus MCRotterdamThe Netherlands,Clinical TechnologyDelft University of TechnologyDelftThe Netherlands
| | - Noor Borren
- Biomedical Imaging Group RotterdamDepartment of Radiology & Nuclear MedicineErasmus MCRotterdamThe Netherlands,Clinical TechnologyDelft University of TechnologyDelftThe Netherlands
| | - Vera Ederveen
- Biomedical Imaging Group RotterdamDepartment of Radiology & Nuclear MedicineErasmus MCRotterdamThe Netherlands,Clinical TechnologyDelft University of TechnologyDelftThe Netherlands
| | - Ella Fokkinga
- Biomedical Imaging Group RotterdamDepartment of Radiology & Nuclear MedicineErasmus MCRotterdamThe Netherlands,Clinical TechnologyDelft University of TechnologyDelftThe Netherlands
| | - Danilo Andrade De Jesus
- Biomedical Imaging Group RotterdamDepartment of Radiology & Nuclear MedicineErasmus MCRotterdamThe Netherlands,Research Group OphthalmologyDepartment of NeurosciencesKU LeuvenLeuvenBelgium
| | - Luisa Sánchez Brea
- Biomedical Imaging Group RotterdamDepartment of Radiology & Nuclear MedicineErasmus MCRotterdamThe Netherlands
| | - Stefan Klein
- Biomedical Imaging Group RotterdamDepartment of Radiology & Nuclear MedicineErasmus MCRotterdamThe Netherlands
| | - Theo van Walsum
- Biomedical Imaging Group RotterdamDepartment of Radiology & Nuclear MedicineErasmus MCRotterdamThe Netherlands
| | - João Barbosa‐Breda
- Research Group OphthalmologyDepartment of NeurosciencesKU LeuvenLeuvenBelgium,Ophthalmology DepartmentCentro Hospitalar e Universitário São JoãoPortoPortugal,Cardiovascular R&D CenterFaculty of Medicine of the University of PortoPortoPortugal
| | - Ingeborg Stalmans
- Research Group OphthalmologyDepartment of NeurosciencesKU LeuvenLeuvenBelgium,Department of OphthalmologyUniversity Hospitals LeuvenLeuvenBelgium
| |
Collapse
|
17
|
Wågström J, Malmqvist L, Hamann S. Optic Nerve Head Blood Flow Analysis in Patients with Optic Disc Drusen Using Laser Speckle Flowgraphy. Neuroophthalmology 2020; 45:92-98. [PMID: 34108780 DOI: 10.1080/01658107.2020.1795689] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
Visual field defects are common in patients with optic disc drusen (ODD). Our aim was to examine whether reduced optic nerve head (ONH) microcirculation is related to visual field defects in ODD patients. Vascular and tissue area mean blur rate (MBRV and MBRT), measured using laser speckle flowgraphy (LSFG), was significantly lower in the 32 included ODD eyes when compared with 40 healthy eyes (p <.05). There was a moderate correlation between the difference in MBRT and the perimetric mean defect (R2 = 0.53) in ODD patients. These findings demonstrate the utility of LSFG in examining ONH blood flow in ODD patients.
Collapse
Affiliation(s)
- Jakob Wågström
- Department of Ophthalmology, Rigshospitalet, Glostrup, Denmark
| | - Lasse Malmqvist
- Department of Ophthalmology, Rigshospitalet, Glostrup, Denmark
| | - Steffen Hamann
- Department of Ophthalmology, Rigshospitalet, Glostrup, Denmark.,Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| |
Collapse
|
18
|
Girard MJA, Schmetterer L. Artificial intelligence and deep learning in glaucoma: Current state and future prospects. PROGRESS IN BRAIN RESEARCH 2020; 257:37-64. [PMID: 32988472 DOI: 10.1016/bs.pbr.2020.07.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Over the past few years, there has been an unprecedented and tremendous excitement for artificial intelligence (AI) research in the field of Ophthalmology; this has naturally been translated to glaucoma-a progressive optic neuropathy characterized by retinal ganglion cell axon loss and associated visual field defects. In this review, we aim to discuss how AI may have a unique opportunity to tackle the many challenges faced in the glaucoma clinic. This is because glaucoma remains poorly understood with difficulties in providing early diagnosis and prognosis accurately and in a timely fashion. In the short term, AI could also become a game changer by paving the way for the first cost-effective glaucoma screening campaigns. While there are undeniable technical and clinical challenges ahead, and more so than for other ophthalmic disorders whereby AI is already booming, we strongly believe that glaucoma specialists should embrace AI as a companion to their practice. Finally, this review will also remind ourselves that glaucoma is a complex group of disorders with a multitude of physiological manifestations that cannot yet be observed clinically. AI in glaucoma is here to stay, but it will not be the only tool to solve glaucoma.
Collapse
Affiliation(s)
- Michaël J A Girard
- Ophthalmic Engineering & Innovation Laboratory (OEIL), Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore.
| | - Leopold Schmetterer
- Ocular Imaging, Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore; School of Chemical and Biomedical Engineering, Nanyang Technological University, Singapore, Singapore; SERI-NTU Advanced Ocular Engineering (STANCE), Singapore, Singapore; Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore; Department of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria; Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria; Institute of Clinical and Experimental Ophthalmology, Basel, Switzerland.
| |
Collapse
|
19
|
Beykin G, Norcia AM, Srinivasan VJ, Dubra A, Goldberg JL. Discovery and clinical translation of novel glaucoma biomarkers. Prog Retin Eye Res 2020; 80:100875. [PMID: 32659431 DOI: 10.1016/j.preteyeres.2020.100875] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2020] [Revised: 06/01/2020] [Accepted: 06/04/2020] [Indexed: 12/16/2022]
Abstract
Glaucoma and other optic neuropathies are characterized by progressive dysfunction and loss of retinal ganglion cells and their axons. Given the high prevalence of glaucoma-related blindness and the availability of treatment options, improving the diagnosis and precise monitoring of progression in these conditions is paramount. Here we review recent progress in the development of novel biomarkers for glaucoma in the context of disease pathophysiology and we propose future steps for the field, including integration of exploratory biomarker outcomes into prospective therapeutic trials. We anticipate that, when validated, some of the novel glaucoma biomarkers discussed here will prove useful for clinical diagnosis and prediction of progression, as well as monitoring of clinical responses to standard and investigational therapies.
Collapse
Affiliation(s)
- Gala Beykin
- Spencer Center for Vision Research at Stanford University, 2370 Watson Ct, Palo Alto, CA, 94303, USA.
| | - Anthony M Norcia
- Department of Psychology, Stanford University, 290 Jane Stanford Way, Stanford, CA, 94305, USA.
| | - Vivek J Srinivasan
- Department of Biomedical Engineering, University of California, Davis, One Shields Ave, Davis, CA, 95616, USA; Department of Ophthalmology and Vision Science, University of California Davis School of Medicine, 4610 X St, Sacramento, CA, 96817, USA.
| | - Alfredo Dubra
- Spencer Center for Vision Research at Stanford University, 2370 Watson Ct, Palo Alto, CA, 94303, USA.
| | - Jeffrey L Goldberg
- Spencer Center for Vision Research at Stanford University, 2370 Watson Ct, Palo Alto, CA, 94303, USA.
| |
Collapse
|
20
|
Szegedi S, Hommer N, Kallab M, Puchner S, Schmidl D, Werkmeister RM, Garhöfer G, Schmetterer L. Repeatability and Reproducibility of Total Retinal Blood Flow Measurements Using Bi-Directional Doppler OCT. Transl Vis Sci Technol 2020; 9:34. [PMID: 32832239 PMCID: PMC7414639 DOI: 10.1167/tvst.9.7.34] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Accepted: 04/28/2020] [Indexed: 12/01/2022] Open
Abstract
Purpose To investigate the repeatability and reproducibility of total retinal blood flow measurements using a custom-built dual-beam bidirectional Doppler optical coherence tomography (OCT) system in healthy subjects. Methods Repeatability and reproducibility were analyzed in 10 and 34 healthy subjects, respectively. For repeatability, measurements were taken twice within 30 minutes, for reproducibility, twice within two to five weeks. Two analysis approaches were compared for calculation of absolute blood velocities: a previously published approach resulting in values for total arterial (QA,abs) and total venous blood flow (QV,abs) and a novel approach taking into account that there is a fixed relation between the phase shift in the two OCT channels (QA,new, QV,new). Repeatability and reproducibility were quantified using intraclass correlation coefficients (ICCs). Results For QA,abs and QV,abs, ICC values between 0.78 and 0.84 were obtained. QA,new and QV,new values revealed better repeatability and reproducibility as compared to the convential appoach. Repeatability ICCs for QA,new and QV,new were between 0.91 and 0.93, and reproducibility ICCs were between 0.87 and 0.91 indicating excellent reproducibility. Good agreement was observed between total retinal blood flow values as measured from retinal arteries and retinal veins. Conclusions Measurement of total retinal blood flow using dual-beam Doppler OCT shows excellent reproducibility, which can further be improved by using a novel algorithm for calculating blood velocities in retinal vessels. Translational Relevance Our data indicate that dual-beam Doppler OCT can be used for longitudinal studies. Hence, quantitative retinal blood flow may be established as a biomarker for progression vascular eye diseases.
Collapse
Affiliation(s)
- Stephan Szegedi
- Department of Clinical Pharmacology, Medical University of Vienna, Austria
| | - Nikolaus Hommer
- Department of Clinical Pharmacology, Medical University of Vienna, Austria
| | - Martin Kallab
- Department of Clinical Pharmacology, Medical University of Vienna, Austria
| | - Stefan Puchner
- Department of Clinical Pharmacology, Medical University of Vienna, Austria.,Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Austria
| | - Doreen Schmidl
- Department of Clinical Pharmacology, Medical University of Vienna, Austria
| | - René M Werkmeister
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Austria
| | - Gerhard Garhöfer
- Department of Clinical Pharmacology, Medical University of Vienna, Austria
| | - Leopold Schmetterer
- Department of Clinical Pharmacology, Medical University of Vienna, Austria.,Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Austria.,Singapore Eye Research Institute, Singapore National Eye Centre, Singapore.,School of Chemical and Biomedical Engineering, Nanyang Technological University, Singapore.,SERI-NTU Advanced Ocular Engineering (STANCE), Singapore.,Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Medical School, Singapore.,Institute of Clinical and Experimental Ophthalmology, Basel, Switzerland
| |
Collapse
|
21
|
Abe M, Omodaka K, Kikawa T, Nakazawa T. Radial peripapillary capillary density in superior segmental optic hypoplasia measured with OCT angiography. BMC Ophthalmol 2020; 20:199. [PMID: 32448227 PMCID: PMC7245833 DOI: 10.1186/s12886-020-01453-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Accepted: 04/27/2020] [Indexed: 11/10/2022] Open
Abstract
Background To investigate the diagnostic power of radial peripapillary capillary (RPC) density, measured with optical coherence tomography angiography (OCT-A), in patients with superior segmental optic hypoplasia (SSOH). Methods Forty subjects with SSOH and 40 age- and axial length-matched control subjects were retrospectively registered for this study. SSOH was defined as intraocular pressure less than 21 mmHg with the presence of two of the following: superior rim thinning, superior entrance of the central retinal artery, scleral halo, and pale optic disc; as well as non-progressive visual field loss. RPC density was measured with swept-source OCT-A (Triton, Topcon) overall, in the quadrants, and in the 12 clock-wise sectors. Changes in RPC density were also compared in SSOH patients and age-matched patients with mild- or moderate-stage of glaucoma. RPC density was compared in pairs of groups with Welch’s t-test. Diagnostic power was assessed with the area under the receiver operating characteristics curve (AUC). Results Overall cpRNFLT was significantly different in the normal (106.7 ± 9.5 μm) and SSOH (77.2 ± 13.7 μm, p < 0.001) subjects. RPC density overall and in the superior, nasal, and inferior quadrants was significantly lower in the SSOH group (all, p < 0.001), but not in the temporal (p = 0.756) quadrant. The diagnostic power of RPC density was highest in the superior quadrant (AUC = 0.928) and the 1 o’clock sector (0.896). Comparing the SSOH and glaucoma patients showed that there were no significant differences in RPC density either overall (p = 0.391) or in the superior quadrant (p = 0.268), while RPC density was significantly higher in the inferior (p = 0.005) and temporal quadrants (p < 0.001) and lower in the nasal quadrant (p = 0.029). Conclusions Low RPC density was found in the three non-temporal quadrants of the optic nerve head in SSOH patients, in comparison to normal subjects. Regionally, RPC density in SSOH was lower in the nasal quadrant and higher in the inferior and temporal quadrants in comparison to glaucoma patients. Measuring RPC density with OCT-A may help the diagnosis of SSOH and may improve the management of glaucoma.
Collapse
Affiliation(s)
- Maiko Abe
- Department of Ophthalmology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Kazuko Omodaka
- Department of Ophthalmology, Tohoku University Graduate School of Medicine, Sendai, Japan.,Department of Ophthalmic Imaging and Information Analytics, Tohoku University Graduate School of Medicine, Sendai, Japan
| | | | - Toru Nakazawa
- Department of Ophthalmology, Tohoku University Graduate School of Medicine, Sendai, Japan. .,Department of Ophthalmic Imaging and Information Analytics, Tohoku University Graduate School of Medicine, Sendai, Japan.
| |
Collapse
|
22
|
Nakazawa T, Fukuchi T. What is glaucomatous optic neuropathy? Jpn J Ophthalmol 2020; 64:243-249. [PMID: 32394134 DOI: 10.1007/s10384-020-00736-1] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Accepted: 02/14/2020] [Indexed: 10/24/2022]
Abstract
Glaucomatous optic neuropathy (GON) is the pathohistological feature of glaucoma in the optic nerve. The pathogenesis of GON has been hypothesized, to either originate from compromised mechanical conditions at the lamina cribrosa or as associated with pathological vascular involvement. From a historical perspective, glaucoma is the degeneration of retinal ganglion cells (RGC) due to the elevation of intraocular pressure (IOP). The consensus of glaucoma treatment is generally accepted as sufficient IOP reduction. Is there an additional option to treat GON from the perspective of the vascular theory? In this section, two distinguished leaders in glaucoma research advance their views and discuss the current opinions surrounding the two theories regarding the causes of GON in primary open angle glaucoma (POAG) and normal tension glaucoma (NTG).
Collapse
Affiliation(s)
- Toru Nakazawa
- Department of Ophthalmology, Tohoku University Graduate School of Medicine, Sendai, Japan.
| | - Takeo Fukuchi
- Division of Opthalmology and Visual Science, Graduated School of Medical and Dental Sciences, Niigata University, Niigata, Japan.
| |
Collapse
|
23
|
Kuroda F, Iwase T, Yamamoto K, Ra E, Terasaki H. Correlation between blood flow on optic nerve head and structural and functional changes in eyes with glaucoma. Sci Rep 2020; 10:729. [PMID: 31959837 PMCID: PMC6971248 DOI: 10.1038/s41598-020-57583-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Accepted: 12/31/2019] [Indexed: 11/23/2022] Open
Abstract
The purpose of this study was to determine the significance of the correlations between blood flow on the optic nerve head (ONH) using the mean blur rate (MBR) determined by laser speckle flowgraphy and the visual field loss determined by perimetry and the structural alterations by optical coherence tomography in eyes solely with open-angle glaucoma. There were significant differences in the circumpapillary retinal nerve fiber layer thickness (cpRNFLT), and the MBR-tissue, at the different stages of glaucoma (ANOVA, P < 0.001). Univariate linear regression analyses indicated that the mean deviations (MD) were significantly correlated with both the MBR-tissue (r = 0.661, P < 0.001) and the cpRNFLT (r = 0.279, P = 0.005). Logistic regression analyses showed that the MD was significantly correlated with the MBR-tissue (P < 0.001) and the cpRNFLT (P < 0.001). The MBR-tissue was found to be the factor that can best predict the MD based on the Akaike information criteria (P < 0.001). Stepwise multiple logistic regression analyses showed that the MBR-tissue and the cpRNFLT were both risk factors that were significantly associated with the MD (Odds ratio;1.25 and 1.07, P < 0.001 and P < 0.001, respectively). These results indicate that the MBR-tissue was as important as the structural values in diagnosing and determining the prognosis of glaucoma.
Collapse
Affiliation(s)
- Fumi Kuroda
- Department of Ophthalmology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Takeshi Iwase
- Department of Ophthalmology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
| | - Kentaro Yamamoto
- Department of Ophthalmology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Eimei Ra
- Department of Ophthalmology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Hiroko Terasaki
- Department of Ophthalmology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| |
Collapse
|
24
|
Gender differences in the influence of obstructive sleep apnea on optic nerve head circulation. Sci Rep 2019; 9:18849. [PMID: 31827230 PMCID: PMC6906515 DOI: 10.1038/s41598-019-55470-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Accepted: 11/28/2019] [Indexed: 01/23/2023] Open
Abstract
We investigated gender differences in the optic nerve head (ONH) microcirculation status in association with obstructive sleep apnea (OSA) by using laser speckle flowgraphy (LSFG). We evaluated 150 men (60.5 ± 11.0 yrs) and 45 women (63.0 ± 10.6 yrs) who underwent overnight polysomnography. The mean blur rate (MBR), maximum (Max) MBR, and minimum (Min) MBR were evaluated. The parameters were analyzed separately for the tissues, vessels, and throughout the ONH (All). The apnea hypopnea index (AHI: times/hr), the lowest SpO2%, and the mean SpO2% were calculated as indicators of OSA. We investigated which MBR sections are correlated with OSA parameters separately in the men and women. All MBR sections in the women were significantly positively correlated with the lowest SpO2. In the men, no MBR section was correlated with any OSA parameters. The factors contributing independently to MBR-Tissue were height (β = 0.31) and lowest SpO2 (β = 0.30). The lowest SpO2 in the women was significantly positively correlated with Max MBR-Tissue, Max MBR-All, and Min MBR-All. Our results confirmed a gender difference in characteristics of ONH microcirculation in association with OSA.
Collapse
|
25
|
Kobayashi T, Shiba T, Kinoshita A, Matsumoto T, Hori Y. The influences of gender and aging on optic nerve head microcirculation in healthy adults. Sci Rep 2019; 9:15636. [PMID: 31666674 PMCID: PMC6821724 DOI: 10.1038/s41598-019-52145-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Accepted: 10/12/2019] [Indexed: 02/07/2023] Open
Abstract
Potential differences in the nature of the influences of aging and gender on the optic nerve head (ONH) microcirculation, using laser speckle flowgraphy (LSFG) were evaluated. We studied 908 healthy subjects (men = 701, age: 50.0 ± 9.1 yrs, women = 208, 49.8 ± 9.5 yrs, p = 0.76). The average, maximum (Max), and minimum (Min) mean blur rate (MBR) in a heartbeat were evaluated. The parameters were analyzed separately for the tissue, vessels, and throughout the ONH (All). We investigated which MBR sections are correlated with gender and age by univariate and multivariate regression analyses. The Max MBR-All (r = −0.31) was most strongly correlated with gender (men = 1, women = 0). The Min MBR-All (r = −0.24) was most strongly correlated with age, followed by Min MBR-All (r = −0.20). The factors contributing independently to the Max MBR-All were gender (β = −0.15), pulse pressure, spherical refraction, ocular perfusion pressure, and red blood cell (RBC) count. The factors contributing independently to the Min MBR-Vessel were gender (β = −0.09), age (β = −0.25), body mass index, heart rate, and spherical refraction. The factors contributing independently to the Min-MBR-All were age (β = −0.22), heart rate, and RBC count. Our results revealed that gender differences influence the Max MBR, and aging influences the Min MBR. These correlations were stronger than that of average MBR.
Collapse
Affiliation(s)
- Tatsuhiko Kobayashi
- Department of Ophthalmology, School of Medicine, Toho University, Tokyo, Japan
| | - Tomoaki Shiba
- Department of Ophthalmology, School of Medicine, Toho University, Tokyo, Japan.
| | - Ayako Kinoshita
- Department of Ophthalmology, Japan Community Health Care Organization, Tokyo Kamata Medical Center, Tokyo, Japan
| | - Tadashi Matsumoto
- Department of Ophthalmology, School of Medicine, Toho University, Tokyo, Japan
| | - Yuichi Hori
- Department of Ophthalmology, School of Medicine, Toho University, Tokyo, Japan
| |
Collapse
|
26
|
Kohmoto R, Sugiyama T, Ueki M, Kojima S, Maeda M, Nemoto E, Tokuoka S, Ikeda T. Correlation between laser speckle flowgraphy and optical coherence tomography angiography measurements in normal and glaucomatous eyes. Clin Ophthalmol 2019; 13:1799-1805. [PMID: 31571818 PMCID: PMC6750712 DOI: 10.2147/opth.s213031] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Accepted: 08/13/2019] [Indexed: 11/24/2022] Open
Abstract
Purpose To investigate the relationship between laser speckle flowgraphy (LSFG) and optical coherence tomography angiography (OCTA) measurements of the peripapillary retina and optic nerve head (ONH) in normal eyes and eyes with primary open-angle glaucoma (POAG). Patients and methods One eye from each of 46 normal subjects and mild and moderate/advanced POAG patients were included. ONH blood flow acquired by LSFG, circumpapillary vessel density (cpVD, a 250 μm-wide elliptical annulus around the optic disc), and intra-papillary vessel density (ipVD, a 1.5×1.5 mm scan field) acquired by OCTA were measured. Their values were compared among normal controls and patients at each stage of glaucoma using one-way ANOVA, and the correlation between measurements obtained by the two methods was examined by univariate regression analysis. Results ONH tissue blood flow, tissue mean blur rate (MBR-T), and cpVD in the outer layer of the retina significantly decreased with the progression of glaucoma stage, although the latter showed no significant difference between normal subjects and mild-stage glaucoma patients. MBR-T was significantly correlated with cpVD, but not with ipVD, in the retinal outer layer. Conclusion A correlation was found only between MBR-T and cpVD in the retinal outer layer. A difference in MBR-T, but not in cpVD, was detected between normal controls and mild glaucoma patients.
Collapse
Affiliation(s)
- Ryohsuke Kohmoto
- Department of Ophthalmology, Osaka Medical College, Takatsuki, Japan
| | - Tetsuya Sugiyama
- Department of Ophthalmology, Osaka Medical College, Takatsuki, Japan
| | - Mari Ueki
- Department of Ophthalmology, Osaka Medical College, Takatsuki, Japan.,Department of Ophthalmology, Takatsuki Red Cross Hospital, Takatsuki, Japan
| | - Shota Kojima
- Department of Ophthalmology, Osaka Medical College, Takatsuki, Japan
| | - Michiko Maeda
- Department of Ophthalmology, Osaka Medical College, Takatsuki, Japan
| | - Emika Nemoto
- Department of Ophthalmology, Osaka Medical College, Takatsuki, Japan
| | - Satoru Tokuoka
- Department of Ophthalmology, Hokusetsu General Hospital, Takatsuki, Japan
| | - Tsunehiko Ikeda
- Department of Ophthalmology, Osaka Medical College, Takatsuki, Japan
| |
Collapse
|
27
|
Kim JS, Kim YK, Baek SU, Ha A, Kim YW, Jeoung JW, Park KH. Topographic correlation between macular superficial microvessel density and ganglion cell-inner plexiform layer thickness in glaucoma-suspect and early normal-tension glaucoma. Br J Ophthalmol 2019; 104:104-109. [PMID: 30940619 DOI: 10.1136/bjophthalmol-2018-313732] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Revised: 02/25/2019] [Accepted: 03/13/2019] [Indexed: 11/04/2022]
Abstract
BACKGROUND/AIMS To investigate the topographic relationship between macular superficial microvessel density (SMD) and macular ganglion cell-inner plexiform layer (GCIPL) thickness in eyes with glaucoma-suspect (GS) and early normal-tension glaucoma (NTG). METHODS A total of 86 eyes of 86 patients with early NTG (standard automated perimetry mean deviation >-5.5 decibels) and a total of 25 eyes of 25 patients with GS were retrospectively reviewed. All of the subjects underwent optical coherence tomography (OCT) and OCT angiography (OCTA) scan. On the OCTA scan images, macular SMD was analysed by customised software. RESULTS In GS and patients with early NTG, macular GCIPL thickness showed significant correlations with macular SMD in the superotemporal (ST), inferotemporal (IT) and inferoinferior (II) sectors (r =0.191, 0.373 and 0.346 for ST, IT and II sector, respectively). Additionally, circumpapillary retinal nerve fibre layer (RNFL) thickness and macular SMD showed significant correlations between the ST sector of the macula and the 1, 9 clock-hour peripapillary regions and between the IT and II sectors of the macula and the 6, 7, 8 clock-hour peripapillary regions. The IT sector macular SMD showed fair diagnostic power (area under the receiver operating characteristic curve [AUROC] = 0.758) and showed high diagnostic power when combined with IT sector macular GCIPL thickness (AUROC=0.954). CONCLUSIONS Sectoral macular SMD showed topographic correlations with macular GCIPL thickness and circumpapillary RNFL thickness in patients with GS and early-stage NTG. Macular SMD analysis is potentially useful in the clinical evaluation of early glaucoma.
Collapse
Affiliation(s)
- Jin-Soo Kim
- Department of Ophthalmology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Young Kook Kim
- Department of Ophthalmology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Sung Uk Baek
- Department of Ophthalmology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Republic of Korea
| | - Ahnul Ha
- Department of Ophthalmology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Yong Woo Kim
- Department of Ophthalmology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Jin Wook Jeoung
- Department of Ophthalmology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Ki Ho Park
- Department of Ophthalmology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| |
Collapse
|